Asrin Karimi1, Ali Delpisheh2, Kourosh Sayehmiri3. 1. Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, IR Iran. 2. Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, IR Iran. 3. Prevention of Psychosocial Injuries Foundation, Research Center, Ilam, IR Iran.
Abstract
CONTEXT: Breast cancer is the most common cancer and the second common cause of cancer-induced mortalities in Iranian women. There has been a rapid development in hazard models and survival analysis in the last decade. AIMS: The aim of this study was to evaluate the prognostic factors of overall survival (OS) in breast cancer patients using accelerated failure time models (AFT). SETTING AND DESIGN: This was a retrospective-analytic cohort study. SUBJECTS AND MATERIALS: About 313 women with a pathologically proven diagnosis of breast cancer who had been treated during a 7-year period (since January 2006 until March 2014) in Sanandaj City, Kurdistan Province of Iran were recruited. STATISTICAL ANALYSIS USED: Performance among AFT was assessed using the goodness of fit methods. Discrimination among the exponential, Weibull, generalized gamma, log-logistic, and log-normal distributions was done using Akaik information criteria and maximum likelihood. RESULTS: The 5 years OS was 75% (95% CI = 74.57-75.43). The main results in terms of survival were found for the different categories of the clinical stage covariate, tumor metastasis, and relapse of cancer. Survival time in breast cancer patients without tumor metastasis and relapse were 4, 2-fold longer than other patients with metastasis and relapse, respectively. CONCLUSION: One of the most important undermining prognostic factors in breast cancer is metastasis; hence, knowledge of the mechanisms of metastasis is necessary to prevent it so occurrence and treatment of metastatic breast cancer and ultimately extend the lifetime of patients.
CONTEXT: Breast cancer is the most common cancer and the second common cause of cancer-induced mortalities in Iranian women. There has been a rapid development in hazard models and survival analysis in the last decade. AIMS: The aim of this study was to evaluate the prognostic factors of overall survival (OS) in breast cancerpatients using accelerated failure time models (AFT). SETTING AND DESIGN: This was a retrospective-analytic cohort study. SUBJECTS AND MATERIALS: About 313 women with a pathologically proven diagnosis of breast cancer who had been treated during a 7-year period (since January 2006 until March 2014) in Sanandaj City, Kurdistan Province of Iran were recruited. STATISTICAL ANALYSIS USED: Performance among AFT was assessed using the goodness of fit methods. Discrimination among the exponential, Weibull, generalized gamma, log-logistic, and log-normal distributions was done using Akaik information criteria and maximum likelihood. RESULTS: The 5 years OS was 75% (95% CI = 74.57-75.43). The main results in terms of survival were found for the different categories of the clinical stage covariate, tumor metastasis, and relapse of cancer. Survival time in breast cancerpatients without tumor metastasis and relapse were 4, 2-fold longer than other patients with metastasis and relapse, respectively. CONCLUSION: One of the most important undermining prognostic factors in breast cancer is metastasis; hence, knowledge of the mechanisms of metastasis is necessary to prevent it so occurrence and treatment of metastatic breast cancer and ultimately extend the lifetime of patients.